Visualization of fibrous cap thickness and rupture in human atherosclerotic carotid plaque in vivo with high-resolution magnetic resonance imaging
Visualization of fibrous cap thickness and rupture in human atherosclerotic carotid plaque in vivo with high-resolution magnetic resonance imaging
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DOI：
10.1161/01.cir.102.9.959
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发表时间：
2000-08-29
期刊：
影响因子：
37.8
通讯作者：
Yuan, C
中科院分区：
文献类型：
--
作者：
Hatsukami, TS;Ross, R;Yuan, C
研究背景：动脉粥样硬化晚期病变的研究结果表明，覆盖在坏死核心上的纤维帽的厚度将稳定病变与破裂和血栓栓塞事件的高风险病变区分开来。我们已经开发出一种高分辨率的MRI技术，可以识别病变的精细结构，包括纤维帽，在体内。本研究的目的是确定在体内的MRI和病变结构之间的协议，所看到的组织学和大体组织检查，以确定纤维帽厚度和rupture.Methods和Results-Twenty两个主题谁是预定的颈动脉内膜切除术进行了MRI与三维多重叠薄板血管造影协议。在MRI、大体和组织学切片上，纤维帽的外观被分类为（1）完整、较厚，（2）完整、较薄，或（3）破裂的纤维帽。36个研究中心可用于MRI和组织学之间的比较。MRI和组织学结果之间的一致性水平较高：89%一致性，kappa（95% CI）= 0.83（0.67 - 1.0），加权kappa = 0.87。斯皮尔曼的相关系数为0.88（显着的0.01的水平）。结论-这些研究结果表明，高分辨率MRI与三维多个重叠的薄板血管造影协议是能够区分完整的，厚的纤维帽完整的薄和破坏帽在体内动脉粥样硬化的人颈动脉。这种非侵入性技术有可能允许研究检查纤维帽变化和临床结果之间的关系，并允许试验评估旨在“稳定”纤维帽的治疗。
Background-The results of studies of advanced lesions of atherosclerosis suggest that the thickness of the fibrous cap that overlies the necrotic core distinguishes the stable lesion from one that is at high risk for rupture and thromboembolic events. We have developed a high-resolution MRI technique that can identify the fine structure of the lesion, including the fibrous cap, in vivo. The aim of the present study was to determine the agreement between in vivo MRI and lesion architecture as seen on histology and gross tissue examination to identify fibrous cap thickness and rupture.Methods and Results-Twenty-two subjects who were scheduled for carotid endarterectomy underwent MRI with a 3-dimensional multiple overlapping thin slab angiography protocol. The appearance of the fibrous cap was categorized as (1) an intact, thick, (2) an intact, thin, or (3) a ruptured fibrous cap on MRI, gross, and histological sections. Thirty-six sites were available for comparison between MRI and histology. There was a high level of agreement between MRI and histological findings: 89% agreement, kappa (95% CI) = 0.83 (0.67 to 1.0), weighted kappa = 0.87. Spearman's correlation coefficient was 0.88 (significant to the 0.01 level).Conclusions-These findings indicate that high-resolution MRI with a 3-dimensional multiple overlapping thin slab angiography protocol is capable of distinguishing intact, thick fibrous caps from intact thin and disrupted caps in atherosclerotic human carotid arteries in vivo. This noninvasive technique has the potential to permit studies that examine the relationship between fibrous cap changes and clinical outcome and to permit trials that evaluate therapy intended to "stabilize" the fibrous cap.